ABSTRACT
Acute hepatitis A with concomitant Graves’ disease was reported rarely in the literature. To our knowledge there is one case in the literature from New York in which acute hepatitis A infection was not thought predominant. It is difficult to manage these cases because of the limited therapy options especially when cholestasis occurs. A 36-year-old male presented with severe cholestasis who was diagnosed as acute hepatitis A infection together with Graves’ disease. He had severe cholestasis with elevated liver enzymes and bilirubin levels. Thyroid functions tests decreased to normal levels with plasmapheresis therapy and then he was sent to general surgery for thyroidectomy. Plasmapheresis is an alternative therapy option for thyrotoxicosis in patients with Graves’ disease concomitant with acute HAV infection.